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Weirdly Low OGTT Means... What?

Hi, guys. I was here quite a few years ago with my first baby, and lo,
I'm about 13 weeks on now and back. And wah wah I need to know if
anyone has been through anything like what I'm seeing now!

With my first pregnancy, I had borderline sugars on the 3-hour OGTT;
they didn't call it GD, but the doc told me not to drink juice and left
it at that. Well, I up and have an 8-lb. 10-oz. baby (a full two pounds
larger than any baby anyone's had on either side of my family, I might
add) whose blood glucose crashed dramatically at birth. They took quite
a few hours stabilizing her. (I know, some people thing GD is a crock;
there's real diabetes in my family, though, and I think I've got some
reason for, well, concern.)

SO I'm with a new obstetrician now, and given this history, she sent me
for the fasting one-hour OGTT a couple of weeks ago, with the idea of
keeping a closer eye on things this time around. I've been feeling
TERRIBLE* for weeks and my mom has been on me to get some kind of
glucose monitoring in place, so I called up a few days ago. The doc was
on vacation, but the nurse gave me my result of the one-hour challenge:
66 ml/Dl, or I guess 3.63 mmol/l. In her words, it was "absolutely
perfect," but the magic of the internet tells me this might be
considered hypoglycemic... Anyway, I was quite a bit surprised, given I
was expecting, well, a HIGH number! I'm not even sure how it's possible
to get such a LOW number on a glucose challenge, and I don't see my
doctor again for about another week. ...Isn't the one-hour number
supposed to be the highest one?

*Terrible: In my case, I mostly feel OK in the morning... until I eat
something. Between 10 and 20 minutes after I eat, I begin to feel
queasy, headachy, foggy of brain, and absolutely STARVING. If I have
another snack, I mostly feel OK while I'm eating and then for another
10 or 20 minutes and then I'm back to nauseated and absurdly hungry...
Tends to get progressively worse as the day goes on. I've been trying
to eat lots more protein in the past couple of days on the advice of
some family members, and it seems to help a lot, but I don't know that
avoiding grains and potatoes for the duration is exactly healthy,
either.

So on to the questions... has anyone heard of anything quite like this
before? Should I kick up some sort of fuss if my doctor thinks it's no
big deal? Am I reading too much into things? I'm not ruling out the
possibility that I'm a histrionic hypochondriac...

Andrea Phillips wrote:
*Terrible: In my case, I mostly feel OK in the morning... until I eat
something. Between 10 and 20 minutes after I eat, I begin to feel
queasy, headachy, foggy of brain, and absolutely STARVING. If I have
another snack,

What are you eating?
I mostly feel OK while I'm eating and then for another
10 or 20 minutes and then I'm back to nauseated and absurdly hungry...
Tends to get progressively worse as the day goes on. I've been trying
to eat lots more protein in the past couple of days on the advice of
some family members, and it seems to help a lot, but I don't know that
avoiding grains and potatoes for the duration is exactly healthy,
either.

Sugars are metabolized really quickly. Starches a little less quickly.
Proteins a little less quickly than that. Fats, even less quickly.
So, the key, when you're hypoglycemic (which I am and it sounds like
you are) is to eat a balance.

This is why if you eat cold cereal for breakfast, you're ready to eat
anything you can get your hands on by 10 am, but if you eat a cheese
omelet, you're not even hungry by lunch.

In your shoes, I would eat a small cheese omelet or scrambled eggs with
cheese, a piece of whole grain toast with butter, a big glass of milk,
and an orange or banana for breakfast (protein - check, starch - check,
sugar - check, fat - check). Then I'd have a midmorning snack of some
cheese and a couple whole grain crackers, and maybe a big glass of
water. Lunch should again balance protein/carbs/fat, but you want to
make sure you get some fiber, too... Leafy greens are good. A big
salad with some meat, cheese, and eggs on it, and a whole wheat roll is
a good option. Afternoon snack of something like cottage cheese and
fruit or veggies with dip. Supper of meat, veg, starch - a chicken
breast, steamed veggies, and a potato with butter and sour cream. A
pre-bed snack may help ward of morning sickness, too.

If you do this type of eating, then as the sugar from the fruit at
breakfast is being used up, the starch from the toast will start being
"burned," then as that's used up, the protein from the eggs is going,
and then as that's used up, the fat is going... Your blood sugar won't
crash because you didn't eat enough to sustain you until your snack.
The midmorning snack will sustain you until lunch - think of it as
waves on the ocean, the first one is sugar, the next is starch, the
next is protein, the next is fat, and you want to ride the crests of
the waves all day long, so that you're always on the peak of one, and
you never get into a trough - the troughs are where you'll get the
yucky symptoms you're describing.

The key to eating this way and not becoming a whale (to continue the
ocean metaphor) like me is portion control! A three egg omelet and a
piece of bread the size of a dinner plate is going to make you fat. A
1 egg omelet and a normal sized piece of bread will keep you in shape.
If you get hungry, try to snack on fruits (be careful, some are loaded
with sugar) and veggies.

It ****es me off that I know all of this intellectually, but I can't
put it into practice long enough to lose weight. Damn the Oreos!

"Andrea Phillips" wrote in message
ups.com...
Thanks so much for your speedy response, Amy!

What you're suggesting seems a bit like what I've been trying to do the
last couple of days, with good result. I woke up Friday morning and had
a couple of hard-boiled eggs and a piece of toast with a tiny bit of
allfruit on it, and a mug of tea, and I felt the best I'd felt in weeks
and weeks. The night before, I'd had a plate of baked ziti (meat sauce
and lots of cheese) and some sauteed broccoli for dinner, and I felt
positively miserable. I guess finding the right ratios is an art?

I can see how if I'm suffering some kind of pregnancy-induced
hypoglycemia, the way I've been eating before could have been largely
to blame. I've been so unbelievably hungry, I've been eating two
breakfasts, three lunches, and snacks in between, and feeling horribly
ill all the while... and that's sadly not exaggerating, either. At
least I haven't been gaining weight out of it. =| My breakfasts tend to
be string cheese and fruit, or chai and a nut bar or other granola bar,
or tea and toast with butter... and my lunches range from cups of
noodles to tuna sandwiches or fried egg sandwiches, canned soup,
various frozen meals, and again, sometimes a few of these in a row
because I keep feeling like if I ate the *exact perfect thing*
(whatever THAT might be) I would finally feel better for more than a
few minutes. Looking back, I can see I've probably been low on protein
and high on starch all the while.

I tend to be a grazer, too, and I'm thinking I might have to try to
stop that. (A boss used to make fun of me, it can take me over three
hours to finish a grande latte from Starbucks.)

At any rate... in your experience and opinion, is it worthwhile to see
if my doctor will send me to a nutritionist? (I know, you're not my
doctor, etc., etc. There's so much conflcting information out
there... I see advice saying I should go practically no-carb, and I see
advice saying I should have juice and toast and corn flakes for
breakfast!

Anyway, thank you again. It's really heartening to hear from someone
who's (maybe) been in the same kind of place as me.

Hi Andrea,

Have you had your thyroid levels checked in the last 14 days? Hypoglycemia
and extreme appetite are common first symptoms of hyperthyroidism. Thyroid
problems very commonly develop in pregnancy. I'm hypoglycemic even when I'm
not pregnant, but when my thyroid levels go up, I have to eat constantly and
the hypoglycemia is much worse. Just to be safe, I'd ask your OB to do a
TSH, Free T3, and Free T4 test. Demand the 'free' T's tests because they
are less affected by other hormones and are more accurate in pregnancy than
the total and uptake thyroid tests and most OBs don't seem to know that.
Even if you can't pin down a cause, I'd see a nutritionist. It helped me
immensely. In the meantime, think peanut butter, boiled eggs, nuts, and
cheese first when you think of snacks rather than fruit or veggies then
add the veggies as a first choice rather than sugary fruits.

Heather, that's an interesting thought, thanks for sharing it. I think
as part of my last blood draw they did a CBC, which includes some
thyroid tests (doesn't it?) At any rate, I've moved up my next
appointment to tomorrow instead of next week. I can't stand the tension
every time I open my mouth to eat, wondering i THIS is something I'll
be able to tolerate or if it's the thing that will make me feel awful
the rest of the day.... sigh.

"Andrea Phillips" wrote in message
oups.com...
Heather, that's an interesting thought, thanks for sharing it. I think
as part of my last blood draw they did a CBC, which includes some
thyroid tests (doesn't it?)

I'm glad you'll be able to get in tomorrow. CBC does not usually include
the three thyroid tests unfortunately. CBC is more of a check for anemia or
infection that checks white blood cells, red cells and iron levels. You'll
have to ask for the TSH, Free T3 and Free T4 as extra tests I'm afraid.

This is what I went through! My diabetic aunt was an INVALUABLE
resource on helping me through (I'm 20 weeks now) with "borderline"
blood sugars. She gave me a new glucose monitor (it was an extra of
hers), but I only used it to baseline my blood sugar last week. The
thing with GD is that you swing back and forth between Hypo and Hyper
blood sugar levels. That is what causes the blood sugars and weight
gain in the baby- her attempt to compensate for your blood sugar
extremes.

So, here's the advice my aunt gave me that has been THE most helpful:
Never eat a starch/sugar/carb without a protein to balance it out.
Eggs with your bowl of cereal, peanut butter sandwich (two slices of
bread have about 30 carbs), etc. Try to stay around 60 carbs for a big
meal, and snacks are great for us because it helps us from having the
big dips in our blood sugar. Eat a protein rich snack before bed (it
keeps you from having that weird barely hungry to starved reaction in
the morning or the reverse that happens later, starved to barely
hungry.) That's about it. It wasn't as complicated as I thought, and
even if my GTT tests fine this time, I will still be doing this because
it turns out to be healthier for the baby and for me. I ususally (this
is my 3rd) have an ENORMOUS weight gain of 65 lbs, but so far I have
lost 4 lbs. and the baby is growing at the right pace, not getting to
be so big! I anticipate 3rd tri to be a little harder, but this way of
eating has also helped me make sure to get all of the right nutrients
into my day since I am now more aware of what I am eating.